Naked Science Forum

Life Sciences => Physiology & Medicine => COVID-19 => Topic started by: EvaH on 08/07/2020 14:44:15

Title: Is early intervention important in treating a coronavirus infection?
Post by: EvaH on 08/07/2020 14:44:15
Eli asks:

Considering what we now know about Covid 19 and happy hypoxia - is it possible that the government advice to not call NHS 111 unless your symptoms have lasted more than 7 days and you’re having significant trouble breathing means many more people have died than necessary? Would you agree that Boris Johnson’s early diagnosis of Covid 19 - meaning he was tested and monitored closely when his symptoms were only considered to be ‘mild’ likely contributed to or at least helped increase the chance of the positive treatment outcome he eventually had? To me as a layman this idea that we should only be monitored by medical specialists when symptoms are severe seems completely counter to the messaging we receive when it comes to other health conditions - like cancer for instance, where we know early intervention greatly increases the chances of survival.

Can you help?
Title: Re: Is early intervention important in treating a coronavirus infection?
Post by: alancalverd on 08/07/2020 15:21:15
The problem is that early symptoms are a bit vague, frequently do not become severe, and are common to most respiratory infections like the common cold and seasonal flu. If everyone demanded oxygen or even a GP appointment at the first sign of a sniffle, the NHS would be overwhelmed all the time.

A good friend saved his own life with a pulse oximeter: recovering from mild symptoms he noticed his O2SAT decreasing rapidly and called 999.

Interestingly, between mid-January and mid-March this year, there were around 5000 fewer deaths in England and Wales than the 5 year average, but in the year to date there have been 54,000 more deaths than expected, so on a first pass we can deduce that something very new has killed 59,000 people so far.  Compare this with

Quote
Since the end of World War II, 7,190 UK armed forces personnel have died as a result of operations in medal
earning theatres.
including Korea, Malaya, Kenya, Cyprus, Afghanistan, Iraq....

Title: Re: Is early intervention important in treating a coronavirus infection?
Post by: set fair on 08/07/2020 16:01:56
I think Eli is right. Anti-viral drugs are more effective the earlier they are taken. Leaving treatment until a patient is ill with covid-19 is overwhelmingly a matter of treating the symptoms. The exception is convalescent plasma therapy.
Title: Re: Is early intervention important in treating a coronavirus infection?
Post by: alancalverd on 08/07/2020 19:52:52
Do we have enough (any?) safe and effective anti-COVID drugs to prospectively dose the entire population?

The nearest we have come to anything like a successful elimination of viral disease by prior dosing was worldwide vaccination against smallpox, which took 70 years. I don't know of any other general chemical prophylaxis apart from oral contraceptives.
Title: Re: Is early intervention important in treating a coronavirus infection?
Post by: evan_au on 08/07/2020 22:53:21
The early intervention that helps everyone is early testing for presence of the virus, based on mild cold/flu/anosmia symptoms.
- And self-isolation until you are declared virus-free

That means you have been infectious and spreading the virus for 1 or 2 days, instead of 7-10 days.

Ideally, there would be a second virus test before ending isolation - there have been people who were in quarantine for 14 days, and released after 14 days without a second test. But they were still infectious, and spread the virus outside quarantine.